UK College of Nursing Employee Health Policy

Introduction
The University of Kentucky College of Nursing Employee Health Policy is designed to provide a means of protection for patients and faculty and staff members with patient-care responsibilities against communicable diseases and work-related infections. This is accomplished by initial and periodic screening of faculty and staff members, taking into consideration the degree of exposure to certain conditions and the specific hazards related to their particular job. Further, it is specifically intended to comply with pre-employment and regular screening requirements imposed by certain state and federal regulations.

Coverage
The objective of the program is to protect both patients and employees from illnesses which could be transmitted while on the job. All College of Nursing faculty and staff members with patient care or patient care related duties must participate in Employee Health as a condition of employment.  This includes those with clinical practice responsibilities, those who supervise students in any clinical area and those with research responsibilities that take them into the clinical arena. Clinical areas include inpatient, outpatient and community-based settings. All College of Nursing faculty and staff members who are practicing as registered nurses, nurse practitioners or clinical nurse specialists and those who are required to be credentialed through Medical Staff Affairs to obtain hospital and clinical privileges must comply with Employee Health as a condition of maintaining those privileges. Any other College of Nursing faculty or staff member with 30 minutes or more of face-to-face cumulative patient contact per month is expected to participate.

The College of Nursing Employee Health Policy also assists in meeting the requirements of the Kentucky Cabinet of Human Resources regulations for tuberculosis screening for all health care workers, OSHA requirements related to hepatitis B and blood-borne pathogen exposures, as well as other state and federal recommendations and requirements for the protection of health care workers.

College of Nursing faculty and staff members with exposure to situations in the workplace, for example, exposure to blood-borne pathogens or who work with certain research animals, which necessitate screening, vaccination or testing will satisfy the OSHA, CDC or occupational safety requirements related to these situations through the College of Nursing Employee Health Policy.

Finally, College of Nursing faculty and staff members not otherwise required to participate in CON-EH may voluntarily participate in the program.

Employee Health Certification
Certification of employee status regarding participation in the College of Nursing Employee Health policy will occur during the initial employment period and will be documented using the Employee Health Certification form to be kept on file in the College personnel file. A copy of the Employee Health Certification form must be presented to the University Health Service by the faculty or staff member at the initial screening.

Initial Screening
The College of Nursing is responsible for screening employees at initial employment (or at the employee’s initial visit to the University Health Service) and at appropriate periodic intervals. It is the responsibility of each faculty and staff member’s associate dean, the College business officer and principal investigators with research staff members to ensure that all employees are seen in Employee Health on a timely basis and prior to their due date for follow-up screening. Initial screening components are as follows:

• Health Questionnaire: Each new faculty or staff member completes a health questionnaire prior to or during the initial visit to the University Health Service to provide baseline health information for determination of the immunizations that are needed or contraindicated. Each faculty or staff member completes the appropriate paper work necessary to begin an Employee Health medical record in University Health Service.
• Tuberculin Skin Test: Each new faculty or staff member (new to the institution or newly designated to participate in the College of Nursing Employee Health Policy) is given a two-step Mantoux tuberculin test in the manner recommended by the Centers for Disease Control (booster method). The two-step booster method may be waived with proper documentation of a negative test within the past five years from an acceptable organization.  (See below for “proper documentation” and “acceptable organization.”) The employee may be required to participate in further health screening; for example, a chest x-ray for a positive skin test.
• Measles, Mumps and Rubella (MMR) Status (for faculty or staff members born in 1957 or after): As a condition of employment, new College of Nursing faculty and staff members with direct patient contact must, upon employment, provide evidence of two MMR’s, documentation of physician diagnosed measles, mumps and rubella or laboratory evidence of rubeola, mumps and rubella immunity. If a faculty or staff member cannot provide this documentation, he/she will receive one MMR at the time of employment and will be revaccinated with the second MMR approximately one month later. New faculty or staff members who have documentation of a single MMR will receive one dose of MMR upon employment. No titers will be drawn.
• Hepatitis B Vaccine (HBV): Within one week of employment, all faculty or staff members who are at potential risk for exposure to human blood or other body fluids are offered the HBV vaccine. The vaccine is offered at no cost to these employees. Each employee receiving HBV signs a consent form which becomes part of the permanent Employee Health medical record. If the faculty or staff member declines the vaccine, OSHA regulations require the supervisor to secure and maintain a signed declination form in the faculty or staff member’s College personnel file. 
  
  Upon completion of the series of three hepatitis B vaccines, hepatitis B antibody titer is drawn, provided the employee returns as directed with 30-60 days. If the titer is negative, a repeat series of immunizations of hepatitis B vaccine is administered in accordance with the recommendations of CDC. If the faculty or staff member received the Hepatitis B vaccination series at the University Health Service, the records will be available at the UHS and no further vaccination is needed. If the faculty or staff member reports having completed the series of three Hepatitis B vaccination at another facility in the past, no further vaccination is needed.
• Varicella:  Faculty or staff members with 30 consecutive minutes or more per month of direct patient care contact are required to demonstrate immunity to varicella either by history of the disease, demonstrated antibody titer or varicella vaccine (completed series of two injections, one month apart). University Health Service staff will, at the initial visit, determine and record the employee’s history of infection with varicella. If a faculty or staff member has a positive history, no further action will be taken. If the history is negative, a varicella titer will be drawn. If positive, no further action will be taken. If the varicella titer is negative, varicella vaccine will be administered.

Faculty or staff members required to have an annual TB test may be satisfy this requirement at UK University Health Service, at any Commonwealth of Kentucky Public Health department, the Lexington VA Medical Center, Shriners Hospital for Children, or Eastern State Hospital. 

Proper documentation must be submitted to the University Health Service Director of Nursing on the official form or letterhead from the testing organization and include:

• Date the test was given
• Test done
• Date the test was read
• Results, including mm. of induration
• Signature and credentials of the test reader

Employee Health Procedure

1.                  Faculty and staff members will be provided the Employee Health Certification form and a copy of the College of Nursing Employee Health policy. The forms are to be signed by the employee and their respective associate dean, business officer or principal investigator (for research staff members). One copy should be given to the College’s business office and will be placed in the employee’s personnel file and one copy should be taken to the UHS by the employee (see item #3 below.).

2.         New Faculty or staff members may pick up a packet from the College’s business officer containing the Employee Health history. This completed form and employee ID badge must be taken with the Employee Health Certification to the University Health Service (UHS).  

3.         The University Health Service is open from 8 a.m. - 4 p.m., but is closed between noon – 1 p.m. The best times to visit are between 8 – 10 a.m. and 2 – 4 p.m. on any weekday except Thursday. (TB skin tests are not given on Thursdays.)

4.         Faculty/staff members return to the College’s business office the copy of the Employee Health certification form received at University Health Service.

5.         The University Health Service sends monthly emails reminders to the administrative coordinator for HR/Payroll regarding employees who need updated immunizations.

6.         The College of Nursing business officer will send monthly reminders to faculty and staff members with a copy to their supervisor when annual TB skin tests are due.

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